Menopause

The 3 stages of menopause 

The dreaded hot flashes and period inconsistencies. As women, we’re familiar with it. Menopause. But did you know there are three stages of menopause? That’s why it can take several years to go through it. 

1. Perimenopause, early/pre menopause or climacteric. This is the start of menopause. Perimenopause begins anywhere between 40 and 55 years old, usually around age 45. It normally lasts 4 to 5 years, but can range anywhere from 2 to 8 years. 
2. Menopause. The average age for menopause in the US is 51. Menopause is complete when you have not had a period for 12 months. 
3. Post menopause. Post menopause begins after your last menstrual period and continues for the remainder of a woman’s lifespan. Rest assured, symptoms will subside as your body adjusts to the changes of menopause.  

As a woman, it is important to understand that menopause is a normal part of our life, and a time of change. It is not an illness and you are not alone. Talk to other ladies your age. You may find out others start go through menopause earlier or later than you thought. You may relate to some of their experiences or you may find out everyone goes through menopause differently, and that is okay. Not everyone experiences the same symptoms, and the range of effects and the degree they appear can differ from person to person. 
 

How do I know if I’m starting menopause? 

The most common and first noticeable sign you may be starting perimenopause, is that your periods will start to change, and this may be accompanied by changes in body temperature or hot flashes. Why?  

During menopause, hormone levels go up and down. Sometimes hormone levels are higher than normal, then lower than normal and then higher again. Perimenopause is when hormone levels first start to decrease.  

Perimenopause begins when your ovaries become less active and make less estrogen and progesterone— hormones that help to keep your monthly periods regular. In addition, your ovaries stop releasing as many eggs. As a result, periods may be shorter, longer, more frequent or less frequent. Sometimes they can be lighter or sometimes heavier. You may have a period some months and skip others. You shouldn't notice a trend or consistent shift in one direction or the other. If this happens, contact your doctor. 
 

More about what to expect during each stage 

The significant shifts in hormone levels can affect women in various ways, not just their menstrual cycle. As early as pre-menopause: 

• Hormone level changes can affect the body’s core temperature and – while hot flashes are not completely understood – some women experience hot flashes.  
• Some women may have difficulty sleeping and/or mood changes. 
• Hormone shifts can also result in an alteration in hair growth pattern. This can result in increased (or loss of) facial hair or body hair, which should be evaluated by your doctor.  

All this occurs for a transient amount of time and can continue into a woman’s menopause and post-menopausal stages/years. Rest assured these symptoms will subside as your body adjusts to the changes of menopause.   

During menopause and post menopause, our production of estrogen, progesterone and testosterone hormones continue to decline. Female reproductive organs gradually shut down, and eventually our periods end. Once you have not had a period for 12 months, menopause is complete and post menopause begins.  

While menopause usually happens naturally as you age, it can also happen for other reasons, including if your ovaries are removed or if you have radiation, chemotherapy, gland disorders or very poor health.  

Menopause is not always a comfortable process. To find out if you’re starting menopause, best understand menopause and find ways to reduce the common discomforts, it’s important to 

• listen to your body,  
• talk with your doctor, and  
• read credible sources.  

A guide to managing menopause 

Unfortunately, there’s no easy fix or “menopause manual,” but the following may help serve as a guide to manage menopause stages and symptoms. 
 

Symptoms of menopause and how to manage 

Irregular periods. Missed periods.	Be prepared for the unexpected by always having extra menstrual products with you.   Keep in mind that even though you may skip periods, it is still possible to get pregnant.
Hot flashes. A sudden feeling of heat that runs through your upper body and into your face. Your face turns red and you start to sweat. You may also feel panicked and short of breath. Each hot flash normally lasts two to three minutes. This can occur for 1 to 2 years and may last up to 10 years.	Wear light layers of loose clothing.  Keep a diary to determine if there is a pattern or triggers to limit or avoid.  Avoid warm temperatures and keep rooms cool, when possible.  Sleep with light blankets or just a sheet.  Purchase a small/portable/personal fan. Run a fan at night.  Drink cold drinks.  Avoid warm or hot drinks, spicy foods, alcohol, caffeine and excessive sugar. (Drink a glass of water if/when you do consume alcohol or caffeine, in moderation.)  Exercise for 30 minutes a day, 3 to 5 times per week. Avoid before bed.  Reduce stress. Relax. Practice controlled breathing techniques and meditation. Try baths to help you relax.  Acupuncture and some dietary supplements (Black Cohosh, Soy, Red Clove, Flaxseed, Vitamin E) may help relieve hot flashes.*
Night sweats.  Hot flashes at night.	Keep your bedroom cool.  Use cotton sheets and pajamas.  Keep a fan and water at your bedside.  Place an ice pack under your pillow.  Acupuncture and some dietary supplements (Soy, Flaxseed, Vitamin E) may help relieve night sweats.*
Trouble sleeping.   You may feel restless or have trouble falling asleep. You may also have a harder time staying asleep or wake up frequently. Night sweats can contribute to this.	Get on a regular sleep schedule—go to bed at the same time every night and get up at the same time every morning.  Use your bed for sleep and sex only.  Keep your room dark and quiet.  Avoid taking naps during the day.  Avoid drinking too much liquid after 8 p.m. to decrease the need to use the bathroom.  Avoid caffeine after mid-day and alcohol after dinner time.  Drink chamomile tea before bedtime, unless you are allergic to ragweed.  Exercise for 30 minutes a day, 3 to 5 times per week, but not after dinner so you have time to wind down.   Dietary supplements may help you sleep easier (Black Cohosh, Valerian Root Extract, Red Clover, Magnesium, Melatonin).*
Mood swings.  Anxiety.  Depression.	Exercise for 30 minutes a day, 3 to 5 times per week.  Practice yoga, prayer, meditation and/or deep breathing techniques.   Laugh often.   Meet/talk with your friends regularly.   Discuss your feelings with your family/friends. Don’t keep them to yourself.  Dietary supplements (Vitamin B6, St. John’s Wort) may help relieve mood swings.*
Decreased or increased sex drive.	Make time to relax and feel good about yourself.  Do things that make you feel attractive.  Practice being playful with sexual activity. Talk to your partner about romance to help with “the mood.”  Contact your doctor if you experience pelvic or vaginal pain.  Contact your doctor if you experience vaginal dryness. There are options.
Wetting your pants.  Leaking urine, especially when coughing or sneezing.	Drink eight glasses of water each day.  Avoid caffeine and alcohol.  Empty your bladder before and after intercourse.  Do Kegel exercises daily.  When you feel you have to go, do not rush. Take a deep breath and walk slowly to the bathroom.
Difficulty concentrating.  Poor memory.	Focus on doing one thing at a time and decrease the number of distractions around you.  Keep lists and write down things you need to remember.  Avoid alcohol.  Take your time.  A dietary supplement that may help with concentration or memory: Gingko Biloba.*
Headaches.	Ibuprofen (Advil).  Acetaminophen (Tylenol).  Aspirin.  Get plenty of sleep.  Eat three low sugar meals and two snacks every day.  Apply heat or cold packs to neck, forehead or eyes.  Avoid personal headache triggers. Keep a diary to identify triggers.  A dietary supplement that may help relieve headaches: Magnesium.*
Back and joint pain.	Ibuprofen (Advil).  Aspirin.  Apply heat or cold packs.  Gently stretch.  Exercise regularly to strengthen muscles.  Lose weight, if necessary.
Breast tenderness.	Avoid caffeine and saturated fats (from animal products).  Wear a supportive bra.  Dietary supplements (Chasteberry, Flaxseed, Soy, Evening Primrose Oil) may help relieve breast tenderness.*
Weight gain.  90 percent of women experience weight gain between the ages of 35 and 60, not coincidentally, during perimenopause and menopause.	Exercise for 30 minutes, 3 to 5 times per week.  Limit sugar/sweets, processed foods and adding salt to foods.  Drink two glasses of water before meals.  Wait 20 minutes after eating to determine if you’re still hungry.  Avoid eating close to bedtime.  Avoid caffeine.

 

*Always check with your health care provider before taking medications or herbal or dietary supplements. Dietary supplements may change how prescription or over-the-counter medications work. There is also no guarantee the ingredients in dietary supplements are safe as they’re not regulated at this time. Don’t take more than the recommended amount, and try one product at a time so you know what works and what doesn’t work for you. It is important to listen to your body and if you have unpleasant side effects, stop taking the product. Keep in mind these medicines are normally recommended for a short period of time. 

 

You can be healthy and feel good during and after menopause! 

During menopause, the hormone changes we experience include too little estrogen, progesterone and testosterone, along with increased insulin. This hormonal fluctuation and imbalance can directly impact our appetite, metabolism and ultimately our weight. Talk to your doctor if you have questions about your weight, nutrition, exercise and lifestyle since this may be connected to the hormone imbalance that perimenopause and menopause can cause and maintaining a healthy weight.  

In addition to the physical changes of menopause, menopause just so happens to occur during a time in life when women are experiencing other life changes. Some women go from raising a family, to having an empty house. Other women may go from raising children, to raising grandchildren. These are major physical and mental changes that take energy and patience. It’s important to be mindful of these things and to take care of yourself during this time. This may mean  

• Taking breaks (from activities or others). 
• Asking for help. 
• Trying out different activities for stress-relief.  
• Making lifestyle changes in order to stay healthy - including different choices about nutrition and exercise. 
• Seeing your doctor regularly for health check-ups.

Rather than looking at menopause as a medical issue, look at it as a life change or a positive symbol of aging and wisdom. This can be a very exciting time in your life as you find you have more freedom—now is the time to take care of yourself both physically and mentally. Accepting menopause as a life transition can help you move forward to find liberation and realize your full potential as a woman. Explore new horizons and take time to experience things you simply haven’t had time for over the years. 

The best thing you can do for yourself is focus on your health and wellness with things that are within your control. Rest assured, you can feel good about yourself while you’re going through menopause. Remember to eat healthy, exercise and relax. If you need to get to a healthy weight, talk to your health care provider about a food plan to gain or lose weight. And also talk to your doctor about other comfort measures, dietary supplements or hormone options.